Medical Insurance Denials & Appeals Coordinator – US Healthcare

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iSTA Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

📦 Logistics

📣 Marketing

Healthcare • Logistics • Marketing

iSTA Solutions is your remote healthcare operations partner specializing in off-site staffing solutions. With over 20 years of experience, we focus on enhancing operational efficiency for businesses, particularly in the healthcare sector, by providing customized remote teams that take on tasks ranging from customer service to data entry. Our goal is to support organizations in scaling their operations seamlessly while achieving significant cost savings and improved productivity.

📋 Description

• Manage medical insurance appeal cases from start to finish • Prepare and submit insurance appeal documentation for denied claims • Compile and organise supporting clinical and administrative documentation • Track appeals, submission deadlines and follow-up dates • Liaise with US insurance companies regarding appeal status and outstanding information • Follow up on pending appeals to ensure timely resolution • Communicate appeal updates and outcomes to the billing team • Request and obtain outstanding documentation required to support appeals • Maintain accurate records and case notes within internal systems • Escalate urgent or time-sensitive matters where appropriate • Complete work accurately, professionally and within required turnaround times

🎯 Requirements

• Minimum 2 years' experience in medical billing, medical claims administration, medical aid administration, healthcare administration, hospital administration, or insurance claims administration • Excellent written and verbal English communication skills • Strong organisational and time management skills • Exceptional attention to detail • Comfortable working with confidential patient information • Confident communicating professionally via telephone and email • Proficient in Microsoft Outlook and Microsoft Office • Able to work independently and manage multiple priorities • Fixed fibre line with minimum 25 Mbps upload and download speed and wired Ethernet capability is mandatory • Reliable power backup is required • Able to work Monday–Friday, 3:00 PM–12:00 AM South African time, subject to daylight saving time • Must work on South African and U.S. public holidays • Experience with US healthcare, medical billing or insurance claims is highly advantageous • Experience handling denied claims or insurance appeals is highly advantageous • Knowledge of Revenue Cycle Management (RCM) is highly advantageous • Experience with behavioural health, hospitals or medical practices is highly advantageous

🏖️ Benefits

• Compensation for South African public holidays in accordance with the BCEA • Fully remote work environment